1. Field of the Invention
This invention relates to an apparatus and method for applying surgical clips, especially hemostatic clips, to body tissue such as blood vessels. More particularly, this invention relates to a surgical clip applier which can be used in laparoscopic or endoscopic procedures for closing arteries, and a method for clipping such tissue.
2. Background of the Related Prior Art
In surgical operations it is often necessary to apply hemostatic clips to blood vessels, and apparatus for applying clips are known in the art. See, for example, U.S. Pat. Nos. 4,616,650 and 4,624,254, both of which are hereby incorporated by reference, which disclose a surgical clip applying apparatus having a pair of ring-like handles. The handles are squeezed to force jaws to move distally relative to the apparatus where they are forced together by a pair of inclined surfaces. A surgical clip between the jaws is thereby squeezed closed.
In laparoscopic procedures surgery is performed in the interior of the abdomen through a small incision; in endoscopic procedures surgery is performed in any hollow viscus of the body through narrow endoscopic tubes inserted through small entrance wounds in the skin. Laparoscopic and endoscopic procedures generally require that any instrumentation inserted into the body be sealed, i.e., provisions must be made to ensure that gases do not enter or exit the body through the laparoscopic or endoscopic incision as, for example, in surgical procedures in which the surgical region is insufflated. Moreover, laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues, and vessels far removed from the incision, thereby requiring that any instruments to be used in such procedures be both long and narrow.
Copending parent application Ser. No. 07/381,265, filed July 18, 1989, discloses an improved apparatus for applying clips to blood vessels which includes a handle section and an endoscopic section which is preferable replaceable when the entire supply of clips are spent. The entire application Ser. No. 07/381,265 is herein incorporated by reference.
While this development represented a major advance in clip applicators, the present invention is directed to further improvements whereby a disposable clip applicator can function to advance and to apply clips in rapid sequence where desirable, while having the capability of becoming locked against further action after the last clip is spent. Since the preferred embodiment of the present invention contemplates a clip applier which is entirely disposable, the endoscopic section is thereby preferably permanently connected to the handle section. Furthermore, the present invention permits ease of gripping while facilitating partial or full closing of each clip without interference with the sequential advancement and closing operation of the endoscopic section.
Because endoscopic procedures are more common than laparoscopic procedures, the present invention shall be discussed in terms of endoscopic procedures and apparatus. However, use herein of terms such as "endoscopic", "endoscopically" and "endoscopic portion", among others, refer generally to instruments having elongated and relatively narrow operating portions for inserting into a cannula or a small wound in the skin and should not be construed to limit the present invention to an apparatus for applying surgical clips only in conjunction with an endoscopic tube. To the contrary, it is believed that the present invention may find use in any procedure where access is limited to a small incision, including, but not limited to laparoscopic procedures.